Fish oil for immunity of patients with postoperative gastrointestinal cancer: a Meta-analysis

Objective To evaluate the efficacy of fish oil for immunity of patients with postoperative gastrointestinal cancer. Methods PubMed, Cochrane Library, CNKI, VIP, and Wanfang Datebases were searched, while only randomized controlled trials (RCT) were included. The immune efficacy outcomes of fish oil in patients with gastrointestinal cancer were compared. The quality of included literature was assessed by the risk of revised Jadad scale. Statistical analysis was performed by Revman 5.3 software. Results Thirteen RCTs involving 965 patients (488 in the fish oil group; 477 in the control group) were enrolled into the analysis. Meta analysis showed that the level of IgA, IgG, IgM in the fish oil group were significantly higher than in the control group [SMD=2.14, 95% CI (1.05, 3.23), P=0.0001; SMD=3.23, 95% CI (1.78, 4.69), P<0.000 1; SMD=2.40, 95% CI (1.17, 3.63), P<0.000 01]. The proportions of CD4+/CD8+ in the fish oil group were significantly higher than the control group [SMD=0.47, 95% CI (0.31, 0.62), P<0.000 01]. The level of C-reactive protein (CRP) in the fish oil group was significantly lower than the control group [SMD=-9.29, 95% CI (-12.02, -6.55), P<0.000 01]. The rate of post-operative complications in the fish oil group was significantly lower than the control group [RR=0.30, 95% CI (0.17, 0.54), P<0.000 1]. Conclusion For postoperative patients with gastrointestinal cancer, fish oil can improve immune function, decrease the level of CRP, and reduce the rate of postoperative complications. Key words: Gastrointestinal neoplasms; Fat emulsions, intravenous; Immunity; Meta analysis